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Second Opinion

Should I Get a Second Opinion From an Orthodontist?

By Community, Orthodontics No Comments

While general dentists and online companies sometimes offer teeth-straightening services, getting care from an orthodontic specialist is key. A certified specialist in orthodontics undergoes extensive training after dental school solely focused on preventing, diagnosing and treating irregularities of the teeth and jaw

But how do you go about finding a good orthodontist? And, should you get more than one opinion? Juneau, Bothell, Monroe and Mill Creek orthodontist Dr. Richard Chan is weighing in on the topic. 

Why Should You Get a Second Orthodontist Opinion?

Orthodontists, just like any type of doctor, can have different opinions about a diagnosis and different preferences when it comes to treatments. The cost of braces or Invisalign®, the length of treatment, the technology used, and the insurance plans they accept can also vary depending on the practice. 

If you visit an orthodontist for a consultation, you love the office, and you’re happy with the proposed treatment plan and fees, you might not need a second opinion. However, getting a second orthodontist’s opinion can be incredibly helpful if:

  • You don’t feel a connection with the doctor or team members.
    Orthodontic treatment is an investment and you’ll spend a good amount of time at your orthodontist’s office. You should feel comfortable and confident that the orthodontist and staff have your best interest at heart. Ultimately, you’ll want your smile journey to be a positive experience. Dreading every appointment will make you miserable.If the doctor or team members aren’t accommodating, don’t take the time to listen to your concerns or needs, or your instincts are telling you that it’s not a good fit, schedule an orthodontic consultation at another practice before committing.
  • The practice doesn’t use modern technology.
    Dated decor is one thing, but dated technology is entirely different. When a doctor is still using old technology and older treatments, it means that they haven’t kept up with innovations in orthodontics. It will impact your results, your treatment experience and, in some cases, even your oral health.Getting braces or Invisalign from an orthodontist who stays on the leading-edge of the field will help you achieve the best outcome more efficiently and comfortably. So, consider scheduling another visit at a more modern practice.
  • You’re told your young child needs lengthy interceptive orthodontic treatment.
    Interceptive orthodontic treatment, also called early orthodontic treatment or phase 1 orthodontic treatment, has become more popular over the years. This is where the orthodontist uses appliances while a child is still growing and has some baby teeth to guide jaw development and make room for the permanent teeth to erupt properly.There are absolutely cases where interceptive orthodontic treatment will help your child get the most stable results and avoid the need for jaw surgery or extractions later. However, often times, we can achieve outstanding results without interceptive treatment.At Richard Chan Orthodontics, we treat young patients very conservatively and only recommend phase 1 treatment in rare cases. So, we’d highly recommend a second orthodontist’s opinion if you’ve been told your child needs early interceptive orthodontic treatment, especially if the treatment seems long, elaborate or unnecessary.
  • You’re diagnosed with a complex orthodontic problem that will require extensive and/or costly treatment.
    If you have a complex case and the treatment plan is expensive or complicated (i.e., involves tooth extractions, years in braces, etc.), it doesn’t hurt to get another quote. This will help you decide if the costs and treatment plan are reasonable.
  • The orthodontist recommends surgical orthodontics.
    Surgical orthodontics is when we combine braces or Invisalign with corrective jaw surgery. It’s reserved for adult patients with certain severe skeletal issues that can’t be corrected with braces or Invisalign on their own. The process takes several years, involves major surgery and a serious recovery period, and it can be expensive.While sometimes it is the best option, whenever surgery is involved, you should always get a second opinion. With today’s technology and techniques, surgical orthodontics is becoming less common and many cases that would have required surgery in the past can be treated with orthodontics alone.
  • You’re told you’re not a candidate for Invisalign.
    A second Invisalign opinion is important if it was determined that you’re not a candidate for clear aligners. Of course, some orthodontic problems respond better to one treatment versus another.However, many times, patients are told Invisalign won’t work for them because the orthodontist doesn’t have the product familiarity or case experience to feel comfortable using the treatment for anything more than a mild issue. Getting a second Invisalign opinion from an experienced provider could mean that you can actually get clear aligners without compromising your results. Today more and more complex cases can be treated with Invisalign.
  • You don’t feel confident about the treatment plan, cost of braces or Invisalign, or any other aspect of your care.
    Listen to your instincts. It’s your smile and oral health, and you shouldn’t feel bad about wanting a second opinion from an orthodontist. If you’re not comfortable about any aspect of a proposed treatment plan or a practice, schedule a consultation at another orthodontic office.

Does Insurance Cover a Second Opinion on Braces or Invisalign Treatment?

Insurance coverage for orthodontic treatment varies greatly depending on the dental insurance plan. You’ll want to check with your insurance provider about coverage for treatment, as well as diagnostics, consultations, and second opinions on braces or Invisalign. 

That said, many orthodontists offer free consultations and second opinions, Richard Chan Orthodontics included. Whether you have insurance or not, the exam, diagnostic records, and treatment recommendations are complementary at our practice. 

If you’re wondering how to get a second opinion from an orthodontist, in most cases, it’s as simple as calling the practice and scheduling a consultation. We can’t speak for every office, but at ours, no referral is necessary to book a visit. 

How to Choose a Good Orthodontist

Here are some things to look for when choosing an orthodontist:

  • Location
    Even if you find the best orthodontist, if the office is an hour away, committing to appointments can be tough. At Richard Chan Orthodontics, we have convenient locations in Bothell, Monroe and Mill Creek, WA and Juneau, AK. You can choose the office that’s closest to you.
  • Orthodontist’s Training and Experience
    Be sure the doctor you’re seeing is a certified specialist in orthodontics. Don’t be afraid to ask how long they’ve been practicing and if they’ve treated cases like yours before.
  • Braces or Invisalign Cost
    When Dr. Chan started Richard Chan Orthodontics, his goal was to make high quality treatment accessible to everyone. Our braces and Invisalign are affordable and we accept most insurance plans. We also offer flexible, in-office financing options, including braces and Invisalign for as low as $129 per month.While the braces and Invisalign cost will vary depending on the severity of your case, the practice, your location, and other factors, you shouldn’t have to feel stressed about affording it. When you have treatment that works for your budget, you can focus on doing your part to get great results instead of worrying about the cost.
  • Modern Technology
    When choosing an orthodontist, ask about the technology the practice uses. Orthodontic technology has really evolved and staying up-to-date on it is essential. At our practice, we use advances like digital x-rays, the iTero digital scanner, treatment planning software, and even 3D printers. This allows Dr. Chan to design a smile for you based on your unique facial features. It also helps him achieve the results he promised in a way that’s safe, comfortable, and effective.
  • Treatment Options
    Being happy with your treatment modality will make for a better experience. If you have your heart set on clear braces, be sure the orthodontist offers them. If you want Invisalign, check that the orthodontist is an experienced Invisalign provider.
  • Clean Office
    The pandemic really put a spotlight on hygiene and disinfection practices. But, the truth is, that has always been important in oral health fields. You want an office that’s clean and follows all guidelines for infection control. Any good orthodontist will make your safety a top priority.
  • Friendly Team
    Last, but not least, when choosing an orthodontist, look for a practice with a friendly, welcoming team. If the doctor and staff are nice, informative, and willing to answer your questions, it’s a good indicator of the kind of care they’ll offer.

Book a Free Second Opinion at Richard Chan Orthodontics


The bottom line is, you should feel confident and informed about your treatment and excited to get started. If you’re unsure of an orthodontist’s diagnosis or treatment plan, schedule a complimentary second opinion with our Juneau, AK or Monroe, Bothell, Mill Creek/Everett, WA orthodontist today! There’s nothing to lose with this no-obligation, no-pressure visit and peace of mind to gain. Still need a first opinion? Schedule a complimentary consultation here.

Brush Your Teeth Before Breakfast

10 Habits That Could be Harming Your Teeth

By Dental Care, Orthodontics No Comments

At Richard Chan Orthodontics, we always teach our patients how to keep their teeth healthy so they can make the most out of their treatment. After all, no one wants to invest in braces or Invisalign® and then do something to harm their smile.

Of course, there are obvious things like not brushing or flossing your teeth that will have a negative impact on your oral health. But, there are also a number of common habits and practices that you might not think twice about that can damage teeth too. In this post, Dr. Richard Chan will be sharing what these habits are and how they can affect your smile.

1. Grinding Teeth

Teeth grinding and clenching, called bruxism, can have a significant effect on your teeth. While a mild, daytime teeth grinding habit might not be a huge concern, chronic bruxism, especially if you grind your teeth at night, will cause complications if not addressed.

Teeth grinding often results in excessive wear of the enamel, chipped or fractured teeth, damaged restorations, headaches, pain, temporomandibular joint (TMJ) dysfunction, earaches, loose teeth and more.

Wearing a night guard will help prevent complications by providing cushioning against the grinding forces. Depending on the cause of bruxism, additional treatment could be needed to help stop the habit and minimize or correct teeth grinding damage.

2. Chewing on Ice, Pencils or Other Objects

What does chewing on ice do to your teeth? First, it can wear away your enamel, which protects your teeth from cavity-causing acids. As enamel erodes, teeth are more susceptible to decay, they become sensitive to hot and cold and, if the underlying dentin is exposed, they can even look yellow. Chewing on ice is also a culprit behind cracked and chipped teeth and worn-down bite edges.

Chewing on pens, pencils, fingernails and other hard objects will probably have the same outcome. Hard plastics like pens or anything with sharp edges can lead to hairline cracks in the enamel and injure the soft tissues of the mouth. Plus, any time you put objects in your mouth, you’re also introducing germs.

3. Eating Lots of Starchy Foods Like Potato Chips and Crackers

There’s always a lot of talk about sugar and teeth. But, the bacteria in the mouth feed on carbohydrates, meaning both sugars and starches. When they do, they release acids that leach minerals from the tooth enamel. Frequent acid attacks cause tooth decay. As tooth decay progresses, a hole forms in the tooth, which is what we call a cavity.

In addition to containing carbohydrates, whether or not a specific food is likely to cause cavities also depends on how long it will be in contact with the teeth and how fast the food is eaten.

Starchy foods like potato chips and pretzels are heavy on the carbs, tend to be snacked on at a leisurely pace and get stuck in the teeth. So, they check all of the cavity-causing boxes. In fact, if you’re in the mood for a treat, when it comes to harming your teeth, you’d be better off having a scoop of ice cream than you would a handful of crackers since ice cream is eaten quickly and rinses off the teeth easily.

4. Not Wearing a Mouthguard When Playing Sports

It’s important to wear a mouthguard during any sport or physical activity that could result in a blow to the mouth. Unfortunately, only a handful of sports require a mouthguard, though a large number of dental injuries occur during basketball and baseball where mouthguards aren’t typically worn.

Common orofacial injuries include cuts to the soft tissues of the mouth, chipped, fractured or knocked out teeth and/or a broken jaw. Wearing a mouthguard is a proven way to reduce these types of injury and keep your smile safe. If you have braces, wearing a mouthguard is especially crucial as an injury can damage your appliance and the brackets and wires can cause even more extensive trauma to your mouth.

5. Drinking Soft Drinks, Energy Drinks or Sports Drinks

While you can drink soda with braces, we always encourage moderation because soda is one of the worst drinks for your teeth. It contains a large amount of sugar, giving fuel to your oral bacteria and causing them to release acids. Soda also contains acids itself, including citric acid. Citric acid is bad for your teeth in large amounts because it causes enamel erosion. The one-two punch of sugar and acidity is a major contributor to tooth decay.

Is diet soda better for your teeth? Nope. While you skip the sugar, it still leads to acid erosion. Some diet drinks have more acidity because of the artificial sweeteners. In fact, a study on enamel dissolution from various beverages found no difference between regular and diet versions of the same brand.

Energy drinks, sports drinks, bottled iced tea and lemonade tend to be up there with soda too, as they’re all acidic and high in sugar. The same study on enamel dissolution found that canned iced tea actually caused more enamel erosion than most soda, with the exception of Mountain Dew and Sprite.

The effects of acid on enamel are cumulative, so the prolonged exposure inherent in sipping a carbonated drink makes you more likely to experience teeth damage. Your best bet is to drink plain water. If you do have a soft drink, enjoy a small glass as part of a larger meal and rinse your teeth with water when you finish.

6. Brushing Your Teeth Right After Having Something Acidic

Speaking of acidity, as part of a balanced diet things like tea and citrus fruits are fine and, in the case of fruit, even beneficial. But if you do have something acidic, when you brush your teeth matters. So, should you brush your teeth before or after coffee or your morning orange juice? The answer is, before!

That might sound counterintuitive, but the acidity weakens your enamel for about 30 minutes to an hour after eating or drinking. If you brush your teeth before the pH in your mouth returns to normal, you can inadvertently cause further damage to your enamel while it’s in its temporarily weakened state.

Instead, brush your teeth before breakfast and then rinse your mouth out with water afterwards. If you’re prone to coffee breath, you can chew a piece of sugarless gum to get rid of the odor and encourage saliva production. Or, if you’re not in a rush, wait an hour after having coffee, juice or acidic foods to brush.

7. Using Your Teeth as a Tool

It can be tempting to use your teeth to tear open a plastic package or rip a stubborn tag off, but the habit increases your risk of teeth damage. Using your teeth as a tool can weaken them and cause chips or cracks, leading to pain, infection and aesthetic concerns. Preserve your pearly whites by using scissors instead.

8. Constant Snacking or Sipping

How often you eat and drink is nearly as important as what you eat and drink. Again, every time you eat, plaque bacteria feed on the sugars and starches and release cavity-causing acids. It takes 30 minutes to an hour for your saliva to neutralize the acidity in your mouth. Every sip and bite starts the clock over again, exposing your teeth to more acids.

Snacking also produces less saliva than eating a full meal does. This means food bits aren’t as effectively rinsed away and they sit on the teeth for a longer period of time.

To prevent tooth decay and damage to your teeth, minimize snacking and sipping on anything aside from water. When you do snack, eat something that’s smile friendly and low in carbohydrates like nuts, cheese or carrot sticks. Have sugary or starchy foods and drinks with a meal, so your saliva production is in full gear in order to promote remineralization and whisk away debris.

9. Frequently Indulging in Chewy and Sticky Treats

Just as with the starchy things like chips or crackers, chewy and sticky foods stick in the teeth, making you more susceptible to cavities. Raisins and other dried fruits and gummy bears, Sour Patch Kids, Starburst and other candies are especially harmful because they also contain sugar.

10. Sucking on Hard Candies or Cough Drops With Sugar

As long as you don’t chew them, hard candies, lollipops and cough drops should be better for your teeth since they dissolve and won’t get stuck in the nooks and crannies, right? Unfortunately, no.

These types of foods are high in sugar and still expose your teeth to carbohydrates and acid attacks. Since you’re sucking on them and they dissolve slowly, exposure is prolonged. Steer clear of hard candy and lollipops or opt for sugarless varieties (bonus points if they contain xylitol, which helps fight cavities). If you’re sick and need cough drops, look for sugarless ones or at least rinse your mouth out with water after having one.

Are You Ready to Experience Amazing Oral Health?

Aside from avoiding these teeth damaging habits, you can also improve your oral health with orthodontic treatment. Straight teeth are easier to clean and an aligned bite keeps your jaw healthy and strong. To find out your options for braces or Invisalign in Bothell, Monroe or Mill Creek, WA or Juneau, AK, schedule a complimentary consultation at Richard Chan Orthodontics today!

Teeth grinding guard for braces

Can I Get Braces or Invisalign® if I Grind My Teeth?

By Invisalign, Orthodontics No Comments

Teeth grinding or clenching, technically called bruxism, is common. If you’re one of the millions of people with bruxism, you might be wondering if you can still get braces or Invisalign. Will teeth grinding wear your aligners out? Will you be able to find a teeth grinding guard for braces? In this post, our Juneau, AK and Bothell, Monroe and Mill Creek, WA orthodontist, Dr. Richard Chan, will be going over everything you need to know about bruxism and orthodontic treatment. 

What Causes Teeth Grinding?

There are two types of bruxism: awake bruxism and sleep bruxism. With awake bruxism, you unconsciously clench or grind your teeth while you’re awake. Clenching and grinding teeth in sleep is known as sleep bruxism. 

As for what causes teeth grinding, experts believe it can be due:

  • Stress, anxiety, anger or frustration (awake bruxism is often tied to emotions)
  • Genetics (sleep bruxism tends to run in families)
  • Sleep apnea and other sleep disorders
  • Certain medications
  • Substances (i.e., caffeine, alcohol, tobacco products, etc.)
  • Health conditions, including GERD, Parkinson’s disease, dementia and ADHD
  • Misaligned teeth and bite problems

Complications of Bruxism

Most people don’t need treatment for awake bruxism or occasional, mild sleep bruxism. If you’re chronically grinding your teeth in sleep, on the other hand, it should be treated, because it can cause:

  • Excessive wear of the enamel
  • Fractured or chipped teeth
  • Damaged dental restorations
  • Temporomandibular joint (TMJ) dysfunction and pain
  • Headaches
  • Earaches
  • Pain when chewing
  • Loose teeth
  • Difficulty sleeping

According to Cedars Sinai, many people don’t realize they are grinding their teeth during sleep until a sleep partner mentions it, they wake up with sore facial muscles and stiffness, or a dentist notices certain wear patterns on the teeth. 

Can You Wear Invisalign if You Grind Your Teeth?

Yes, most patients can get Invisalign if they grind their teeth. Chronic teeth grinding with Invisalign could cause the aligners to wear down more quickly. However, since you only wear each set of aligners for one to two weeks, by the time you’re in need of a replacement, you’ll usually be on to your next tray. 

There are rare occasions where someone’s bruxism is so severe that they would wear out their aligners before it was time to change them. In these cases, we will ask Invisalign to give us two sets of each aligner, or getting braces could be the better option. But one advantage of Invisalign is that while you might be grinding your trays down, at least you won’t be grinding your teeth down!

What About Braces and Teeth Grinding?

Yup, you can get braces if you grind your teeth. As we mentioned above, occasionally, braces could be preferable to Invisalign for patients with severe bruxism. 

Will Braces or Invisalign Help With Teeth Grinding?

Whether or not braces or Invisalign can help with teeth grinding depends on what’s causing your bruxism. Bruxism is more prevalent in people with misaligned teeth and, if that’s the case for you, then aligning your teeth with orthodontic treatment will help to reduce the behavior. 

If you grind your teeth when you’re awake, Invisalign aligners can serve as a reminder, making you more aware of the habit. This too can be beneficial for reducing or stopping grinding and clenching. 

It’s important to note though that for some orthodontic patients, teeth grinding gets worse before it gets better. The mild sensitivity that occurs when you start treatment, as well as the shifting of your teeth, can temporarily increase grinding and clenching.  For this same reason sometimes the bruxism will decrease at the beginning of the treatment, as the increase in sensitivity will cause an automatic feedback to stop grinding the teeth.  

Can Invisalign Be Used as a Night Guard?

When it comes to how to stop teeth grinding, a multi-disciplinary approach is often best. Managing the underlying cause of your teeth grinding is important, whether it’s treating a health condition or finding new ways to cope with stress. Additionally, a lot of people also benefit from a special mouth guard for teeth grinding, called a night guard. The appliance helps cushion against the biting or clenching forces to prevent damage to the teeth and jaw. 

If you’re straightening your teeth, can Invisalign be used as a night guard? During your treatment, yes, Invisalign can be used as a night guard to a certain extent. You can’t wear a night guard instead of your aligners because you need to wear your aligners for about 22 hours per day for optimal results. Your aligners are actually pretty similar in design to a night guard and will provide some cushion between the upper and lower teeth. 

Can I Get a Teeth Grinding Guard for Braces?

Since braces don’t cover the entire arch of teeth like aligners do, you can still wear a night guard during your braces treatment. In fact, wearing one will be in your best interest if your bruxism is severe and likely to damage your teeth, jaw and/or appliance. 

Keep in mind that your teeth will shift throughout your braces treatment. This means you’ll have to change your night guard so that it continues to fit. When choosing a teeth grinding guard for braces, a boil-and-bite or custom orthodontic guard will be the most affordable options. With an over-the-counter, boil-and-bite night guard, you can simply make a new one as needed. A custom orthodontic guard will account for your appliance and allow for the movement of the teeth, so you won’t have to constantly replace it. 

Schedule a Complimentary Consultation at Richard Chan Orthodontics Today!

If you clench or grind your teeth and want to learn more about your orthodontic treatment options, schedule a complimentary consultation at our Juneau, AK or Bothell, Mill Creek or Monroe, WA orthodontics office. Dr. Chan will perform a comprehensive exam and assess your diagnostic records in order to provide you with personalized treatment recommendations that will bring out the best in your smile.

A Guide to Preparing Your Child for Braces or Invisalign® Teen

A Guide to Preparing Your Child for Braces or Invisalign® Teen

By Orthodontics, Teen Orthodontics No Comments

When your child first finds out they’ll be getting braces or Invisalign Teen, they’re likely going to have a lot of questions. They might be nervous about the treatment being painful or embarrassed to be the only person in class with braces (fact: they won’t be!). They might be frustrated about the rules of what they can and can’t eat, and how to brush and floss their teeth. We get these questions all the time at Richard Chan Orthodontics, both from our teen patients and their parents. In most cases, kids are simply afraid of the unknown. As parents, you can play a big role in helping them understand what to expect and prepare them as best as possible.

As your child gets ready to start his or her orthodontic treatment, there are many things you can do to ease their concerns and even get them excited (yes, really!). And if you ever have questions, just call your Monroe, Mill Creek, Bothell and Juneau orthodontist. Dr. Richard Chan  and our team are always here to help.

1. Learn All About Braces and Invisalign Together

Beginning any orthodontic treatment can feel a little overwhelming, not only for kids and teens but for their parents too. The first step in preparing for braces or Invisalign is to learn as much as possible about treatment before it actually starts. Research what your child will need to know from the foods they can eat to how to brush and floss. Better yet, get educated together so the whole family knows what to expect. When you’ve done thorough research and discussed all of your child’s treatment options, everyone will feel better equipped to take on life with braces.

2. Let Them Know They’re Not Alone

Many kids don’t want braces or Invisalign, because they think they’ll be the only one they know going through it. But did you know an estimated 80% of teens will have some sort of orthodontic treatment? Chances are your child already has a few friends or classmates with braces or Invisalign. Maybe you even had braces yourself way back when. Reminding your kids that they’re not alone (and that treatment can be a positive experience) can help them get more comfortable with the idea of getting braces.

There are also many celebrities who had braces, even when they were already in the public eye. Drew Barrymore, Kendall Jenner and Dakota Fanning are just a few of Hollywood’s biggest names who straightened their teeth. Once your kids see how common braces are for everyone, they’ll feel better about their own treatment. And seeing the results of braces on the big screen is also an added benefit!

3. Stock the Fridge with Soft Foods

Adapting to life with braces is about more than getting used to seeing a new smile in the mirror. Your kids will also have to adjust their eating habits to make sure they get the most out of their treatment. There are a number of foods to avoid when you have braces, including sticky, chewy, hard, or crunchy foods, or anything you have to bite into (such as apples, corn on the cob or whole raw carrots). 

As a parent, you can make their lives easier by stocking up on and preparing braces-friendly foods. Soft things like yogurt, fruit, soups, smoothies, steamed veggies or ice cream are perfect foods for people with braces, because they’re easy to chew and won’t get caught in your child’s appliance. The best part is that braces-safe foods are usually super healthy, so the whole family can benefit from a braces-friendly diet!

4. Plan Ahead for Discomfort

On top of learning what they can and cannot eat, your child will also have to get used to the feel of braces or Invisalign. With any orthodontic treatment, there can be mild discomfort as the teeth shift and move to their desired position. Braces can cause additional irritation to your child’s lips or the inside of their mouth. Parents can help their kids cope by having orthodontic wax and mild, over-the-counter pain relievers on hand. 

Have your kids take a child-safe medication like Advil before getting their braces tightened or when they’re switching to a new set of Invisalign Teen aligners. If their brackets are causing sores, place orthodontic wax over the uncomfortable part of the braces to reduce irritation. Being proactive about managing discomfort will ensure your kids have a much more positive experience with braces or Invisalign.

 5. Put Together An Invisalign or Braces Emergency Kit

Speaking of planning ahead, putting together an Invisalign or braces emergency kit is the key to being ready for any situation and keeping teeth clean while on the go. Store these items in a toiletry or cosmetic bag and have your child keep the kit on them when they’re at school or activities:
A Travel Toothbrush and Toothpaste

  • A Travel Toothbrush and Toothpaste
    Kids will want to brush their teeth after eating to get rid of any food debris that’s stuck in their hardware. Even those with Invisalign Teen should brush after eating, so their teeth are clean when they put their clear aligners back in.
  • Flossing Tools
    If your child or teen will be getting braces, don’t forget to add dental floss and a floss threader or special orthodontic flossers to their kit. Flossing can get rid of stubborn food that refuses to budge with a toothbrush. Interdental brushes, also called interproximal brushes, are a good addition too. These tiny brushes are able to clean around brackets and can be used to dislodge food.
  • Orthodontic Wax
    As mentioned above, braces wax is effective for stopping irritation and it can be used for minor braces emergencies like a poking wire or broken bracket.
  • Tissues
    Keeping tissues on hand ensures kids can quickly wipe away any spit when they take out their Invisalign aligners. Tissues can also be used to dry off areas of the braces that are causing irritation before applying wax.
  • Hand Sanitizer
    Encourage kids and teens to thoroughly wash their hands before removing or putting in their aligners or applying wax to their braces. If they’re not able to find soap and a sink, hand sanitizer will do the trick.
  • Lip Balm
    Include lip balm for braces and Invisalign wearers. When you have braces or are wearing aligners or a retainer, the lips stretch a bit to fit over the appliance, which can cause or worsen dryness and cracking. Sometimes, after braces adjustments, the lips can feel a bit dry too. Using lip balm will keep lips hydrated and help with any irritation. The best lip balm for braces or Invisalign is one that’s rich and soothing like Burt’s Bees 100% Natural Beeswax Lip Balm or Carmex.
  • Water
    While it might not fit in your child’s braces or Invisalign kit, be sure they bring their reusable water bottle with them when they leave the house. Kids can swish with water after meals and snacks if they forget their toothbrush or after having a sugary beverage. Staying hydrated by drinking water also stimulates the flow of saliva, which helps remineralize teeth and wash away food and plaque to keep cavities away.

6. Set Up A System of Small Rewards

As a parent, you know the real reward for keeping braces clean or wearing clear aligners or rubber bands for the prescribed amount of time is a healthy smile. However, kids and teens don’t always fully appreciate these long-term benefits. That’s why we recommend using a system of small rewards to help kids establish positive habits. Setting your expectations and figuring out a rewards system before kids start treatment will be helpful. 

Think about what motivates your child and then use it to temporarily reward them until the desired habit (i.e., diligently brushing and flossing with braces, wearing Invisalign Teen aligners or rubber bands for 22 hours per day, etc.) is firmly in place. 

For example, you could reward your kiddo with 15 minutes of extra screen time each day they brush their teeth for two full minutes after meals and snacks. Or, they could earn a ticket every time they wear their aligners for 22 hours. When they collect 10 tickets, they then get to go somewhere fun or order takeout from the restaurant of their choice. Get creative and find what works for your family! 

7. Focus on the End Goal

We all know that kids can be impatient and during orthodontic treatment is no different. Your kids will probably be counting down the days until their braces come off or when they can put away their aligners for good. Depending on their length of treatment, they’ll have many months to wait, which can make it hard for them to see how their oral hygiene habits today will impact results down the line. 

To keep them motivated, help them look ahead to the end of treatment when they’ll get to see their perfect smile. Focusing on the outcome will encourage them to stay on track and comply with their orthodontist’s instructions. And before they know it, they’ll be able to proudly show off their brand new smile.

Let’s Work Together to Give Your Child a Healthy, Beautiful Smile!

Still have questions about preparing your child for orthodontic treatment? Whether you want more details about oral hygiene or you’d like additional recommendations for things like the best toothpaste or lip balm for braces, contact us and we’ll be happy to help.

If you’re interested in finding out your child or teenager’s teeth-straightening options, schedule a complimentary consultation at Richard Chan Orthodontics in Bothell, Monroe or Mill Creek, WA or Juneau, AK today!

causes of crooked teeth

8 Common Causes of Crooked Teeth

By Orthodontics No Comments

There’s always that one friend or family member with perfectly straight teeth who never needed braces or Invisalign. It can make you wonder how that’s possible and what’s behind your own misaligned teeth or jaw.

Are crooked teeth genetic? Why do some people have crooked teeth while others don’t? Can misalignment be prevented? In this post, our Bothell, Monroe, Mill Creek, Everett and Juneau orthodontist will be diving into 8 common causes of crooked teeth and what you can do about it.

Are Crooked Teeth in Kids Always a Concern?

Before we cover the causes of crooked teeth, let’s talk about primary teeth. Parents sometimes panic when their child’s teeth aren’t straight, but crooked teeth in kids are not always indicative of a problem.

If your kiddo has crooked baby teeth, they won’t necessarily have crooked permanent teeth. This is especially true for spacing. Spaces or gaps between baby teeth can be a good thing since the permanent teeth are larger and will take up more room once they erupt. For this same reason, however, if your child has significantly crowded baby teeth, there is a chance that the permanent teeth will be crowded too.

The American Association of Orthodontists recommends children have their first orthodontic evaluation by age 7. This might sound really young, but it’s for a good reason. At this age, Dr. Chan can see how your child’s bite is shaping up. We always treat kids conservatively at our practice and most won’t need treatment right away. They’ll simply come in occasionally over the years, so we can pinpoint the ideal time for them to start braces or Invisalign when they’re teenagers.

However, if Dr. Chan does identify red flags like abnormalities with jaw or facial growth or severe crowding, sometimes, intervening early will bring about the best results. In certain cases, he may recommend phase 1 orthodontic treatment, which is when we use orthodontic appliances to guide jaw and facial growth (dentofacial orthopedics) while a child is still developing.

The goal is to correct any skeletal abnormalities and make room for the permanent teeth to come in correctly. When early orthodontic treatment is necessary, it can make later treatment easier and prevent the need for corrective jaw surgery or the extraction of permanent teeth.

Other times, if we identify myofunctional or oral habits (i.e., thumb sucking, tongue thrust, mouth breathing, etc.), which we’ll talk about shortly, we can give parents guidance on correcting the habit. Stopping the habit might not prevent crooked teeth entirely, but it may ward off more serious malocclusion (improper bite) that would require extensive treatment.

What Causes Crooked Teeth?

So, what causes crooked teeth? Here are 8 common culprits:

  1. Genetics
    For a lot of patients, crooked teeth are genetic. If one or both of your parents have crooked teeth, you could also have crooked teeth. The different types of malocclusion, such as an overbite, underbite, open bite and crossbite, while sometimes caused or worsened by oral habits, are often due to the size or position of the jaw. The size of our jaws and teeth are determined by genetics, but they often do not match each other. For example, we might get a smaller jaw from one side of the family, and then larger teeth from the other side, resulting in excess crowding. Or, if the opposite happens, and we get larger jaws with smaller teeth, then we will have excess spacing.
  2. Oral Habits
    Repetitive oral habits like thumb sucking or prolonged pacifier use, especially if the habit continues once the permanent teeth start to erupt, can also be a cause of crooked teeth and a misaligned bite. As a child sucks on their thumb or pacifier, they exert pressure behind the top front teeth. This pressure can cause changes in their palate, as well as lead to protruding or overjet teeth and issues like an open bite.
  3. Orofacial Myofunctional Disorders
    Orofacial (mouth and face) myofunctional (muscle function) disorders, such as mouth breathing and tongue posturing, are also common causes of crooked teeth. When kids have trouble breathing through their nose, whether due to an airway problem or even allergies, they may resort to mouth breathing. Chronic mouth breathing, in turn, can cause problems with their facial development, leading to crooked teeth and all types of malocclusion.
    Tongue thrust, also called reverse swallowing or immature swallowing, is when the tongue hits against or protrudes in between the front teeth when a person swallows or talks. Although the thrusting movement is not enough to cause crooked teeth, the tongue will usually stay in a forward position when at rest too, which does cause problems. Inside of the mouth, the tongue puts pressure against the teeth while, from the outside, the facial muscles exert pressure. The combination can interfere with craniofacial development and cause crooked teeth and bite issues.
  4. The Early Loss of Primary Teeth
    The primary teeth, or baby teeth, are important. It can seem like no big deal if a child loses a baby tooth early since it would have fallen out anyway, but that’s not the case. The baby teeth help with facial and speech development, aid in chewing and, most importantly, save space for the permanent teeth to come in. When a baby tooth is lost before it’s supposed to fall out, and a space maintainer isn’t placed, the remaining teeth will shift into the gap. The permanent tooth won’t be able to erupt correctly and, in extreme cases, can even become impacted (stuck under the tissue or bone), leading to crowding.
  5. Trauma
    Sustaining a dental injury like an elbow to the mouth while playing sports can displace the teeth. If not treated, not only can the one tooth become crooked, but the other teeth may shift to accommodate the damaged tooth.
  6. Not Replacing Missing Permanent Teeth
    If you lose a permanent tooth from periodontal disease, severe decay, an injury or a health condition, it’s essential to replace it with a dental implant or a restoration like a dental bridge. This is because, just like we talked about with a missing baby tooth, when you have a missing permanent tooth that isn’t replaced, the remaining teeth will shift into the space left behind. This will create changes in your bite and can ultimately cause crooked teeth.
    Additionally, since the jawbone isn’t being stimulated anymore where the tooth is missing, the body will resorb the bone. This bone loss might also impact the alignment of your teeth and even the appearance of your face.
  7. Natural Changes With Age
    As we get older, the bite often deepens and the teeth tend to shift naturally. This is why wearing a retainer after braces or Invisalign is the key to maintaining your results. If you forget to wear your retainer, over time, you will experience a relapse. Even if you didn’t need braces or Invisalign before, you might find that your teeth become crooked as you get older.
  8. Dental Work
    Improperly fitting dental restorations like crowns, bridges and fillings can have a negative impact on your bite, causing pain and reduced function, as well as misaligned teeth.

Can Crooked Teeth be Prevented?

There’s no way to guarantee that you’ll have straight teeth and won’t need braces or Invisalign. Crooked teeth and a misaligned bite often have a genetic component and, if that’s the case, they can’t really be prevented.

That said, stopping oral habits such as thumb sucking and pacifier use and seeking out treatment for issues like tongue thrust/posture and mouth breathing, can prevent some bite issues or, at least, ensure they don’t continue to get worse.

Crowding can also be reduced or, sometimes, prevented, by opting for a dental space maintainer for a baby tooth that’s lost too early or by replacing a missing permanent tooth. Lastly, wearing a mouthguard when playing sports or doing any activity that could result in a blow to the face is good practice and will keep your teeth safe and where you want them.

Why Do Crooked Teeth Need to be Fixed?

There are times when slightly crooked teeth or a small gap can add charm to your smile and might not need to be corrected unless you feel self-conscious. But, the truth is, often, crooked teeth should be fixed because:

  • Most importantly, you want a beautiful smile, and your crooked teeth bother you.
  • Some of the teeth will bear more of the brunt when you chew, resulting in excessive or uneven wear of the enamel.
  • They can make chewing difficult or painful when they are in certain wrong positions.

How to Fix Crooked Teeth

We talked about the causes of crooked teeth, whether they’re a concern in kids and why they should be fixed. Now, let’s go over how to fix crooked teeth. The first step is visiting Richard Chan Orthodontics for a complimentary consultation.

We’ll take any necessary diagnostic records, like photos and digital x-rays, and Dr. Chan will complete a thorough examination. He’ll use his findings to develop an accurate diagnosis and personalized treatment recommendations.

Treatment options could include:

  • Metal BracesMetal braces are the original way to fix crooked teeth and they’re still around today, because they’re effective. Modern metal braces are smaller and more streamlined than those of the past. They’re an excellent treatment option for kids, teens and adults, including those with severe orthodontic issues. They tend to be super popular with our younger patients who love getting to personalize their braces with colorful elastics. We have the common silver metal braces, and we also have gold braces for those who prefer them!
  • Clear BracesClear braces, or ceramic braces, work in the same way as metal braces. However, the brackets are crafted from a durable ceramic material that blends in with your smile. They’re much less noticeable than their metal counterparts. Many of our adult braces patients prefer clear braces.
  • Invisalign or Invisalign TeenIf you’re wondering how to fix crooked teeth without braces, Invisalign could be the solution. The system of clear, removable aligners is a convenient, comfortable treatment option. Dr. Chan designs your ideal smile on a virtual, 3D model of your mouth and the aligners are custom-made for you based on his specifications. As you make your way through your aligners, your smile will gradually take shape. The aligners are virtually invisible and since they’re removable, there are no food restrictions and oral hygiene is simple.Invisalign Teen works in the same way as Invisalign for adults. However, the aligners are designed especially for younger patients with features including eruption tabs to accommodate erupting teeth and free replacement aligners included in the system.

Connect with Dr. Richard Chan Today!

If you’re concerned about crooked teeth and you’re ready to find out which treatment option will bring out the best in your smile, we can help. Schedule a complimentary consultation at our Bothell, Monroe or Mill Creek, WA or Juneau, AK orthodontic offices to get started.

food you can eat with braces

60 Tasty Holiday Food You Can Eat With Braces

By Orthodontics No Comments

Whether you celebrate Thanksgiving, Hanukkah, Christmas, anything in between, or all of the above, we know one thing, the festivities will probably include a whole lot of delicious food. While this is one of our favorite parts of the holiday season, we understand that if you have braces, you might be worried you’ll have to skip your favorite dishes. The good news is, with a few exceptions, you can still eat most of the things you normally would. In fact, the team here at Richard Chan Orthodontics is sharing 60 braces-friendly holiday foods to consider adding to your menu this year.

What Food Can You Eat With Braces?

We know, we know, we promised you a list of mouthwatering holiday treats, but let’s have a quick refresher on the foods to eat with braces first. When you get your braces put on and, sometimes after adjustments, your teeth can feel a little bit tender. You’ll want to stick with soft foods, as well as cold foods and drinks, until the sensitivity subsides.

Some of the best soft foods for braces include mashed potatoes, yogurt, applesauce, protein shakes, smoothies, ripe bananas, oatmeal, scrambled eggs, and soup. When you feel ready to tackle your normal diet again, be sure to cut or break food into small, bitesize pieces and chew with your back teeth. Never bite into food with your front teeth. 

What are the Food You Can’t Eat With Braces?

There are some foods to avoid with braces (believe us, it will be well worth your amazing results!). In general, we tell our Alaska, Bothell, Monroe, Mill Creek, and Everett, WA braces patients to stay away from anything really hard, chewy, or sticky that could damage their appliances. Here are a few common holiday foods you can’t eat with braces that fall into those categories:

  • Nuts (either on their own or in foods like stuffing, pecan pie, or brownies)
  • Hard candy, such as candy canes
  • Caramel 
  • Toffee
  • Whole, raw carrots, and other really hard vegetables
  • Candy apples
  • Hard rolls
  • Hard gingerbread cookies
  • Meat on the bone (off the bone is okay)

As you can see, there aren’t a ton of holiday foods you can’t eat with braces and, in many cases, making some adaptations like taking meat off of the bone or thinly slicing raw veggies will make them braces-friendly

60 Holiday Foods to Eat With Braces

 

If you’re feeling bummed about not being able to eat those candied nuts this year, you’ll be happy to know there is so much more you can have! Here are 60 of our favorite holiday food you can eat with braces:

  1. Fork-tender turkey (taken off the bone)
  2. Fork-tender beef (i.e., brisket, roast beef, corned beef, etc.)
  3. Fork-tender lamb (off the bone)
  4. Fork-tender chicken (off the bone)
  5. Fork-tender pork, including ham
  6. Fork-tender duck
  7. Soft-cooked fish, shellfish, and seafood
  8. Meatloaf
  9. Meatballs
  10. Plant-based meat alternatives, such as the Gardein Holiday Roast or Tofurkey
  11. Cooked blackeyed peas, lentils, and other legumes
  12. Tofu
  13. Beans
  14. Salad (thinly slice any crunchy vegetables and forgo the croutons)
  15. Soup
  16. Stew
  17. Soft cheese
  18. Spinach and artichoke dip
  19. Hummus
  20. Pita bread, soft tortillas, or crackers that melt in your mouth like Ritz for dipping
  21. Deviled eggs
  22. Mashed potatoes, mashed sweet potatoes, mashed turnips, etc. 
  23. Baked or roasted potatoes, yams, and/or sweet potatoes
  24. Roasted vegetables (e.g., cauliflower, Brussels sprouts, broccoli, etc.)
  25. Steamed/cooked vegetables (e.g., spinach, collard greens, carrots, green beans, etc.)
  26. Creamed corn or creamed spinach
  27. Corn (take it off the cob)
  28. Green bean casserole (hold the almonds!)
  29. Sweet potato casserole
  30. Latkes
  31. Fritters
  32. Stuffing without nuts
  33. Cranberry sauce
  34. Gravy
  35. Macaroni and cheese
  36. Pasta
  37. Lasagna
  38. Tamales
  39. Dumplings
  40. Pierogies
  41. Spoon bread
  42. Biscuits
  43. Soft rolls
  44. Cornbread
  45. Challah bread
  46. Quiche
  47. Rice
  48. Cooked grains (e.g., barley, farro, etc.)
  49. Eggnog
  50. Cider
  51. Hot chocolate
  52. Soft-baked cookies (yup, that includes gingerbread cookies)
  53. Plain chocolate 
  54. Brownies without nuts
  55. Cake
  56. Pumpkin pie, apple pie, and any other fruit pie
  57. Cream pies
  58. Ice cream
  59. Donuts
  60. Pudding 

This isn’t an exhaustive list and there are many more braces-friendly options. As long as something is relatively easy to chew and isn’t hard, crunchy, or sticky enough to damage your braces, you’re free to enjoy it. 

Give Yourself the Gift of a Healthy Smile

We hope everyone has a happy and healthy holiday season! And, now that you have at least 60 holiday food you can eat with braces, are you feeling ready to perfect your smile? Book a complimentary consultation with Dr. Richard Chan in Mill Creek, Bothell, or Monroe, WA or Juneau, AK.

invisalign gap teeth before

Can Braces or Invisalign Fix Gaps Between My Teeth?

By Orthodontics No Comments

One of the most common reasons our Juneau, AK and Bothell, Monroe, Mill Creek and Everett braces and Invisalign patients visit us is for spacing. Spacing, sometimes referred to as “gap teeth” in layman’s terms and diastema in doctor speak, is when there are spaces or gaps between two or more teeth. 

When it comes to how to fix gaps in the teeth, the first step is to have your smile evaluated by an orthodontist like Dr. Richard Chan. When you visit us for a braces or Invisalign consultation, Dr. Chan will perform an exam and take necessary diagnostic records in order to develop an accurate diagnosis and determine the underlying cause of your orthodontic concerns. He will then create a personalized treatment plan to close the gaps between the teeth for a beautiful, healthy smile and a functional bite.  Read More

swollen gums with braces and smiling

Why Do I Have Swollen Gums With Braces?

By Orthodontics No Comments

You’re in braces treatment, you check out your smile in the mirror, and you notice your gums look red, inflamed, and swollen. Is it par for the course during orthodontic treatment or is it a sign of an oral health issue that needs to be addressed? To give you peace of mind and help you determine what’s normal and what isn’t, our Juneau, AK, Bothell, Monroe, Mill Creek, and Everett, WA orthodontist is sharing everything you need to know about braces and your gums.  Read More

woman-learning-how-to-flossing-with-braces

How To Floss With Braces

By Orthodontics No Comments

The Ultimate Guite To Floss With Braces

When our Alaska, Bothell, Monroe and Mill Creek braces patients first kick-off treatment, we always teach them exactly how to take care of their braces and their smile. Of course, knowing what to do and actually learning new techniques are two different things. For most people, figuring out how to floss with braces takes the most getting used to. To help give you a better idea, we’ll be sharing everything you need to know about flossing with your hardware.  Read More